Provider Demographics
NPI:1699883249
Name:SANDERS, BRANDY LEE (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:LEE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 E PECOS RD
Mailing Address - Street 2:SUITE 516
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-3200
Mailing Address - Country:US
Mailing Address - Phone:480-619-4486
Mailing Address - Fax:
Practice Address - Street 1:1760 E PECOS RD
Practice Address - Street 2:SUITE 516
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-3200
Practice Address - Country:US
Practice Address - Phone:480-619-4486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7273225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist